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Does sex affect anticoagulant use for stroke prevention in nonvalvular atrial fibrillation? : the prospective global anticoagulant registry in the FIELD -Atrial Fibrillation
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(2015) Does sex affect anticoagulant use for stroke prevention in nonvalvular atrial fibrillation? : the prospective global anticoagulant registry in the FIELD -Atrial Fibrillation. Circulation : Cardiovascular Quality and Outcomes, 8 (2 supplement 1). S12-S20. doi:10.1161/CIRCOUTCOMES.114.001556 ISSN 1941-7713.
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Official URL: http://dx.doi.org/10.1161/CIRCOUTCOMES.114.001556
Abstract
Background—Among patients with atrial fibrillation (AF), women are at higher risk of stroke than men. Using prospective cohort data from a large global population of patients with nonvalvular AF, we sought to identify any differences in the use of anticoagulants for stroke prevention in women and men.
Methods and Results—This was a prospective multicenter observational registry with 858 randomly selected sites in 30 countries. A total of 17 184 patients with newly diagnosed (≤6 weeks) nonvalvular AF and ≥1 additional investigator-defined stroke risk factor(s) were recruited (March 2010 to June 2013). The main outcome measure was the use of anticoagulants (vitamin K antagonists, factor Xa inhibitors, and direct thrombin inhibitors) for stroke prevention at AF diagnosis. Of 17 184 patients enrolled, 43.8% were women. More women than men were at moderate-to-high risk of stroke (CHADS2 score ≥2: 65.1% versus 54.7%). Rates of anticoagulant use were not different overall (60.9% of men versus 60.8% of women) and in patients with a CHADS2 score ≥2 (adjusted odds ratio for women versus men, 1.00; 95% confidence interval, 0.92–1.09). In patients at low risk (CHA2DS2-VASc of 0 in men and 1 in women), 41.8% of men and 41.1% of women received an anticoagulant. In patients at high risk (CHA2DS2-VASc score ≥2), 35.4% of men and 38.4% of women did not receive an anticoagulant.
Conclusions—These contemporary global data show that anticoagulant use for stroke prevention is no different in men and women with nonvalvular AF. Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Circulation : Cardiovascular Quality and Outcomes | ||||
Publisher: | Lippincott Williams & Wilkins | ||||
ISSN: | 1941-7713 | ||||
Official Date: | 24 February 2015 | ||||
Dates: |
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Volume: | 8 | ||||
Number: | 2 supplement 1 | ||||
Page Range: | S12-S20 | ||||
DOI: | 10.1161/CIRCOUTCOMES.114.001556 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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